My dad just had a stroke - please help

[michie118]

My dad had heart by-pass surgery one week ago today (last Monday), there were complications so he actually had 2 surgeries that day.  He recovered and was moved out of ICU on Thursday (3 days post surgery).  He had eaten little and was very tired, said he had gotten no sleep since the surgery.
My point is he was very tired before his stroke.  Then, early Friday morning (5th day following surgery) he had an ischemic/clot stroke.  It affected his left side.  He was very groggy that day, but since then he responds to us with firm grips of his left hand (he is right handed), smiles, blinks, and even hugged my mom with his left arm last night; however, he seems SO TIRED sometimes when we visit we don't know if we should even try to communicate with him and try to get him to keep his eyes open.  Several times he has not seemed as sleepy, but today, especially so since some rehab people had apparently worked with him about an hour.  We are only allowed 4- 30 min, visits a day since he is in ICU. We are being very optimistic with him, but please tell me --- should we not talk to him when he is so sleepy? Or should we encourage him to talk, blink, grip our hand, move his foot.  etc.  What is the best thing we can do to help him?  We have been moving his right hand for him, trying to keep his fingers from drawing up.  He does move his right foot when we touch it, but not when we ask him to --- does this mean he is paralyzed or just weak on the right foot/leg?
He does not move his right hand/arm at all.  He has not tried to speak.  The doctors are never around, we are trying to make sure we talk to them today.  Please -any advice is sincerely appreciated!!  Please help me -- I feel so helpless and want to help my dad as much as humanly possible.

[millertime78]

I'm going through exactly the same process as you with my Dad. He had a stoke 8 days ago and is still extremely disoriented, has no memory or speech but on the plus side, he's up walking and is eating (after 5 days). He had an ischemic stroke. My Dad was on Warfarin which is a blood thinner. They have taken him off it since the stroke as they are afraid of a bleed. I haven't seen the neurologist yet but must. As far as I can see with doctors and hospitals, its the people who jump up and down for attention that get seen , otherwise you are ignored.

[michie118]

Thanks so much for your response.  Your comments are really helpful.
We were told blood thinner was given b/c he had a clot that caused the stroke, and they found a clot in his lung the day after the stroke.
Now, because of the bleeding, we are being told (by heart surgeon) he probably shouldn't be on blood thinner for a coupld of months.  Just this morning, they are recommending putting a blood filter in his groin area to catch any clots before they go to his heart, lungs, etc.  They strongly recommend this.  They make it sound like a fairly simple procedure, although there are some small risks.  Basically, they think he is at risk of developing more clots since he has had two and is so sedentary in ICU, and without blood thinner, this is the only thing (they say) can be done in regards to clots.

Sounds like you are lucky that your neurologist and surgeon work closely together.  With us, neurologist(s) just do consults, in fact neurologist that talked to me about my dad's bleed say he just did a consult, did not order any scan, and he was NOT my dad's doctor.  Needless to say, it is kind of scary that a heart surgeon is treating the stroke when he has said he is not a stroke doctor.  Nearest stroke center hospital is 2 hours away, and I know it would probably be detrimental to move my dad at this point.  We are just keeping faith and praying that he will come through this and recover.

Again, thanks so much for you comments and suggestions, gregcs --
michie

[gregcs]

My father, 78, had a left side stroke in Dec 15.  It was a Ischemic stroke (no bleeding).  Unfortunately mostly you have to wait and see what the damages is and how he will recover.  I've done a ton of reseach on sites like this and talked with the Doctors frequently.  Basically, NOBODY can predict what the outcome will be.  Keep positive and upbeat because the outcome will be what it is going to be, no sense in dwelling on the negative.  The percentage are in your favor for significant improvement.  Being healthly and active before the stroke will be in his favor.

While your father needs rest to recover, I would suggest alternating between letting him rest and talking/working with him.  PT told me it was a good idea to gently work my father's range of motion on his right side where there is no movement.  In our hospital PT only see patients once per week when they are in ICU.  However the family is allowed unlimited access.

As far as the Doctors, I find they don't coming looking for me to discuss things.  However, when I call or request a meeting they are happy to discuss whatever I want.  Keep a running log of your discussion.  The nurses are a great source for information because they have the most contact with your father.  Be nice to them, bring cookies, coffee and start up conversations with them.

Moving his foot when you touch it is a good thing.  You'll have to wait to see how much movement he actually has, plus with therapy he can make significant progress.

As far as blood thinner and bleeding - I had the opposite issue.  Right after the stroke my father's surgeon requested a CT scan and if there was NO bleeding he ordered blood thinners.  There was no bleeding, but the Neurologist over ruled the surgeon and delayed the blood thinner for 10 days.  I spoke with both doctors and the Neurologist wanted to delay the blood thinner because he was worried about the risk of bleeding.  The surgeon didn't agree with him but went along with him.  You have the right to ask why that made the decision they did.  Our Neurologist even showed us the various CT scan.  Ask to see the CT scans and have the Neurologist explain them.

Stay strong and optimistic

[michie118]

Neurologist has said my dad also had/has a bleed.  He said there is no way to know if it is still bleeding.  Dad had CT scan on day of stroke, but not another one until 3 days later (today), in the meantime was given blood thinner, now they are saying blood thinner would have contributed to bleed.  Is my dad getting inferior care?  It just seems that everything is an afterthought.  Why wasn't a CT scan done earlier to check for bleeding, for example?  Thanks

[michie118]

I forgot to mention my dad is 68 years old, was very physically active before his heart surgery and stroke --- we were so surprised that he needed the surgery as he always
seemed to healthy and active.